A case of stunned myocardium concomitant with endotracheal intubation
Yokokawa, K.; Yabuki, S.; Hasegawa, M.
Masui. Japanese Journal of Anesthesiology 48(10): 1138-1140
1999
ISSN/ISBN: 0021-4892 PMID: 10554508 Document Number: 502371
"Stunned myocardium" was defined by Braunwald et al in 1982 as reversible postischemic myocardial dysfunction. We report a case of a 57-year-old woman for cholesystectomy who developed stunned myocardium during endotracheal intubation. She was free of any risks of heart disease. While the endotracheal tube was smoothly inserted after rapid induction, the blood pressure was remarkably elevated and electrocardiogram (ECG) showed ST segment elevations in leads I, aVL, as well as V2-V6, and ST segment depressions in leads II, III and aVF. The coronary angiography, performed 2 weeks later, revealed a normal coronary finding, but the left ventriculogram showed asynergy in its anterior and apical walls (AHA segments 2, 3 and 6). Left ventricular dysfunction in this case was possibly due to a direct effect of excessive cathecholamines secreted during an acute episode of hypertension triggered by intubation.